1. Field of the Invention
The present invention relates generally to a multipurpose infant positioning device.
2. Description of Related Art
Preterm infants are born before optimal fetal musculoskeletal and neurologic maturation has completed, and as such, are initially cared for in a neonatal intensive care unit (NICU). Ill infants are also typically cared for in the NICU. Since the womb inherently provides dynamic boundaries for the infant, one of the goals in the NICU is to simulate a womb-like environment for facilitating continued development of the preterm and/or ill infant.
In normal fetal development the uterine boundaries counterbalance the forceful prenatal motor pattern of active extensions forcing the fetus back to a flexed midline position, which is important for development. This flexed midline position is also important for the continued development of preterm and/or ill infants. Since inadequate positioning can result in a variety of issues profoundly impacting the infant's early development, it is important to provide infants with proper postnatal positioning.
Proper infant positioning promotes neurobehavioral organization, musculoskeletal development and neuromotor functioning. The four key concepts in proper therapeutic postnatal positioning are flexion, midline, containment and comfort. There are three typical techniques or orientations used in therapeutic positioning: 1) “supine” (i.e., infant on its back), 2) “prone” (i.e., infant on its belly), and 3) “side-lying” (i.e., infant on one of its sides.) Each has their own medical and developmental advantages. Infants are repositioned frequently, typically every two to four hours or when behavior cues suggest discomfort. Additionally, access to the infant is needed for diapering and maintenance of medical connections such as feeding tubes and ventilator ports. Repositioning and access to the infant should be done with minimal disruption to the infant.
Several types of external supports and devices exist for postnatal therapeutic positioning to compensate for the infant's immature motor control and the lack of the natural boundary of the womb. Often, comfortable boundaries are established to contain the preterm and/or ill infant in a position of gentle flexion and midline orientation of the extremities with the head and trunk supported in neutral alignment with the body. For instance, blankets, towels, bedding and diapers are often used as makeshift devices to support the infant and define these boundaries. These items are typically rolled whereby several are utilized in cooperation to establish and define boundaries. However, these conventional items and approaches suffer from the limitation that they have the tendency to unroll, loosen and/or shift away from their position against the infant, and as such, do not provide secure boundaries that maintain the infant in a desired position for prolonged periods.
Commercial products are also available for facilitating infant positioning to contain preterm and/or ill infants. However, many of these devices suffer from the limitation that they only provide a boundary on a limited portion of the periphery around the infant, whereby these boundaries are limited in restraining the infant within the device. Current commercially available devices are also limited in the therapeutic position that each one supports.
U.S. Pat. No. 4,611,353 discloses an infant garment sack that includes a closed sack portion with a hood and two elongated flaps that each wrap entirely around the infant and meet at the back of the sack. The closed sack portion has an elastic band at a top portion thereof for gathering in the top of the sack around the infant and a cylindrical section of thick, resilient material at the bottom thereof for enabling the infant to dig its toes therein. While this device has a sack portion and flaps, the sack is limited in that the elastic band does not fit securely around all sized infants nor does the sack enable one to gain access to the infant therein (e.g., for repositioning, changing, etc.) without disturbing the infant. Additionally, the flaps have a consistent width over the length thereof, such that, the flaps must be wrapped offset around the infants arms. As the infant's arms move the offset flaps do not provide an adequate boundary that bring back the infant's arms to the desired flexion and midline infant positioning. Another drawback of this infant garment sack is that it is restricted to placing the infant in the supine position (i.e., on its back).
Other commercially available devices are the SnuggleUp®, the Bendy® Bumper and the Cozycare™ Bunting, all of which are available from Children's Medical Ventures. The SnuggleUp® is limited in that it has a lower pad with double straps extending from a single side of the device, it has no boundary for the head, and it has a cushioned restraining footrest. The Bendy® Bumper, while able to be formed to provide a boundary around the periphery of an infant, is not in and of itself able to provide the desirable flexion in the infant. Also, bunting type devices (e.g., the Cozycare™ Bunting) are currently available that are typically composed of a single piece of material that wraps around the infant for containment. Yet, none of these commercially available products support the flexion and midline positioning techniques, which are essential for normal fetal development, for extended periods, nor adequately enough to provide the infant with sufficient support that is required for normal development. The commercially available devices also are limited in the positions they support. For instance, the Prone Plus™ is designed specifically for use in assisting proper prone positioning of an infant. Positioning in multiple orientations would require multiple devices.